Ticket for Outdoor Patient
| Ward No. 0 | U-PHC No. | Registration No. 09913 | Date 08/09/2025 |
| Token No | SM/25-26/7630 08/09/2025 | Serial | 060 |
| Patient Name | Mrs. RINA SHAW | Contact No | 7439026849 |
| Address | GHORAMARA PURBAPARA SERAMPORE 712203 | Age | 39 YRS Female |
| Token For | Visit Doctor, | Charge | Free |
| B.P | mmHg | Weight | KG |
| Pulse Rate | / min | Height | cm |
| Diagnosis | |||